Buckland-Wright J C, Macfarlane D G, Jasani M K, Lynch J A
Division of Anatomy and Cell Biology, United Medical School, Guys Hospital, London, UK.
J Rheumatol. 1994 Sep;21(9):1734-41.
Joint space width (JSW) in osteoarthritis (OA) knee radiography is reported to be optimally assessed from semiflexed standing and tunnel views although no detailed assessment of tunnel view radiography of OA knees has been done. The primary objective of our study was to determine the incidence of joint space narrowing (JSN) in semiflexed standing vs weight bearing tunnel views. The data were also analyzed to examined the degree and relationship of JSN and bony features of OA in the 2 views.
Ninety OA knees had macroradiographs at 5 times magnification taken in weight bearing standing semiflexed and weight bearing tunnel views. JSW and OA related bony features were measured and compared with reference values obtained from the knees of 14 healthy volunteers without arthritis.
Comparison of JSW between the 2 radiographic views identified 3 locations of cartilage loss: JSN recorded in the tunnel only (22%), that in standing view only (8%), and that in both the views (30%). Subchondral sclerosis and osteophytes were significantly larger in 40% of OA knees despite a normal JSW. The tunnel view also enabled better visualization and measurement of osteophytes.
Standing semiflexed view radiography alone failed to detect JSN in 22% of OA knees. Combined standing and tunnel radiographic views detected JSN more frequently than either view alone. Bony changes were radiographically evident without the presence of JSN indicative of cartilage thinning in as many as 40% of the patients with OA studied.
据报道，骨关节炎（OA）膝关节X线摄影中的关节间隙宽度（JSW）在半屈曲站立位和隧道位视图下评估最为理想，尽管尚未对OA膝关节的隧道位X线摄影进行详细评估。我们研究的主要目的是确定半屈曲站立位与负重隧道位视图中关节间隙变窄（JSN）的发生率。还对数据进行了分析，以检查两种视图中JSN的程度以及OA的骨特征之间的关系。
对90个OA膝关节在负重站立半屈曲位和负重隧道位视图下进行5倍放大的放大X线摄影。测量JSW和与OA相关的骨特征，并与14名无关节炎的健康志愿者膝关节获得的参考值进行比较。
两种X线视图之间JSW的比较确定了软骨丢失的3个位置：仅在隧道位记录到的JSN（22%），仅在站立位记录到的（8%），以及在两种视图中均记录到的（30%）。尽管JSW正常，但40%的OA膝关节中软骨下硬化和骨赘明显更大。隧道位视图还能更好地显示和测量骨赘。
仅半屈曲站立位X线摄影未能在22%的OA膝关节中检测到JSN。站立位和隧道位X线视图联合检测到JSN的频率高于单独使用任何一种视图。在多达40%研究的OA患者中，在没有JSN（提示软骨变薄）的情况下，骨改变在X线片上很明显。
